ABSTRACT
From 1997 to 1998 the first series of 21 patients with large biliary tract stones (1.5-4.0 cm with average 2.5 cm in diameter) who underwent endoscopic stone extraction by using combination of ERCP and EST with automatic stone-tissue detection pulse dye laser was carried out. Male = 8, Female = 13, average age = 57.5 years (32-83) most of the stones were primary stones (71.4%). Laser fibers were controlled by balloon catheter with fluoroscope (blind technique) in 16 cases and by mother-babyscope system in 5 cases. The result in successful fragmentation of stones was 87.5 per cent with the blind technique and 100 per cent with the mother-babyscope technique. Temporary stents were used in the patients who had severe cholangitis and those who required more than one session of lithotripsy (19%). Complications consisted of controllable cholangitis in 2 cases (9.5%) and there was no mortality. We conclude that stone-tissue detection lithotripsy is very safe and effective in patients with large biliary tract stones and high surgical risk especially via the direct mother-babyscope system.
Subject(s)
Adult , Aged , Aged, 80 and over , Bile Duct Diseases/diagnosis , Cholangiopancreatography, Endoscopic Retrograde , Cholelithiasis/diagnosis , Female , Follow-Up Studies , Humans , Lithotripsy, Laser/methods , Male , Middle Aged , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
One hundred and sixty nine surgical patients at Siriraj Hospital were assessed foe their nutritional status. There were 119 males and 50 females. The abnormality in weight for height, haematocrit, serum albumin and total lymphocyte count were 56.4, 60.0, 30.8, 27.5 percent respectively. Two or more abnormal paramenters were detected in 49.8 percent of the patients. Significant protein-calorie malnutrition occurs in the hospital